You can also check in with them to see if they are processing the information how you are delivering it by asking if you are making sense. Give them information in small chunks, then pause to give them time to digest the information or ask questions. This may be more serious than we originally hoped.The situation may be a little more serious than that.You can give patients a quick heads up that they are going to hear bad news with a “warning shot.” You might say things like: Don’t use euphemisms, but don’t be excessively blunt either. No matter how much information you are giving them, you should keep terms simple and be direct. Once you understand the level of information your patient wants, it is time to deliver the news and teach them about their health. Would it be OK if we talk about some serious issues with your care?.Would it be helpful for you to know what to expect from here on out with your illness?.To find out what your patient wants, simply ask questions like: Other patients will want to know everything possible about their illness and treatment. They may only want broad strokes, but no details. Patients have the right to know or not know certain things about their condition. You will then need to determine how much the patient or their family wants to know about their situation. You may find that the patient is in denial about the seriousness of their illness or that they don’t have a good understanding of their health. These questions help give you a baseline for how the patient, or their family, feels about their condition and how they might react. Tell me what you know about your mother’s health.How do you think your illness will affect you?.For instance, you may ask questions like: Once you are in an appropriate setting, you need to assess what the person knows about the situation. Then take a seat so both you and the people you are speaking to feel more comfortable. Before you begin delivering the news, make sure proper introductions are made with everyone in the room. You may want other care team members with you or you may want to ensure that a patient has a support person with them. Next, make sure that everyone who needs to be present is present. Tell other staff members that you need privacy so they can steer clear of the area. You should also ensure the room is private and that you won’t be interrupted during your conversation. That usually means a time when you can speak to them as long as they need and won’t be rushed out of the room. S - Settingįirst, choose the right setting and time to speak to your patient, visitor or coworker. If you have a situation where you are delivering bad news, follow the SPIKES framework for empathetic conversation. By using this structure for your conversation, you can feel more confident in your ability to communicate clearly and empathetically, even in the worst situations. Especially now, in the time of COVID-19, you may need to use SPIKES frequently to speak honestly and sensitively to the people you are caring for. For health care providers, SPIKES may be used daily or even multiple times per day.
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